During the past 10 years, very few new cephalosporins have been introduced for pediatric use. Cefepime is a fourth-generation cephalosporin used for parenteral treatment of serious infections. Cefepime has enhanced activity against gram-negative enterics that often are resistant to multiple antibiotics, including those producing extended-spectrum β-lactamases or hyperproducing AmpC enzymes, and it retains good activity against gram-positive cocci. Cefepime is useful for treating nosocomial infections caused by multiresistant gram-negative enterics and has advantages over ceftazidime for empirical treatment of the febrile neutropenic child with cancer. Cefdinir is an extended-spectrum oral cephalosporin that has activity against organisms associated with upper respiratory tract infections comparable with that of cefuroxime or cefpodoxime. Cefdinir suspension is well tolerated by children and as a single daily dose is equivalent to amoxicillin-clavulanate for treating acute otitis media in children. Cefdinir is the oral cephalosporin to consider as second-line therapy for treatment of acute otitis media or acute bacterial sinusitis for children who are unresponsive to or intolerant of amoxicillin-clavulanate. Copyright © 2001 by W.B. Saunders Company